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Oxidative stress causes several diseases and dysfunctions in cells, including oocytes. Clearly, oxidative stress influences oocyte quality during in vitro maturation and fertilization. Here we tested the ability of coenzyme Q10 (CoQ10) to reduce reactive oxygen species (ROS) and improve mouse oocyte quality during in vitro culture. Treatment with 50 μM CoQ10 efficiently reduced ROS levels in oocytes cultured in vitro. The fertilizable form of an oocyte usually contains a cortical granule-free domain (CGFD). CoQ10 enhanced the ratio of CGFD–oocytes from 35% to 45%. However, the hardening of the zona pellucida in oocytes was not affected by CoQ10 treatment. The in vitro maturation capacity of oocytes, which was determined by the first polar body extrusion, was enhanced from 48.9% to 75.7% by the addition of CoQ10 to the culture medium. During the parthenogenesis process, the number of two-cell embryos was increased by CoQ10 from 43.5% to 67.3%. Additionally, treatment with CoQ10 increased the expression of Bcl2 and Sirt1 in cumulus cells. These results suggested that CoQ10 had a positive effect on ROS reduction, maturation rate and two-cell embryo formation in mouse oocyte culture.
We aimed to identify the association of hydration status with insulin resistance (IR) and body fat distribution. A total of 14 344 adults participated in the Korea National Health and Nutrition Examination Survey 2008–2010. We used urine specific gravity (USG) to indicate hydration status, and HOMA-IR (homoeostasis model assessment of IR) and trunk:leg fat ratio (TLR) as primary outcomes. In multivariate logistic regression, the OR per 0·01 increase in USG for high IR was 1·303 (95 % CI 1·185, 1·433; P < 0·001). In multivariate generalised additive model plots, increased USG showed a J-shaped association with logarithmic HOMA-IR, with the lowest Akaike’s information criterion score of USG 1·030. Moreover, increased USG was independently associated with increased trunk fat, decreased leg fat and increased TLR. In mediation analysis, the proportion of mediation effects of USG on TLR via IR was 0·193 (95 % CI 0·132, 0·285; P < 0·001), while the proportion of mediation effects of USG on IR via TLR was 0·130 (95 % CI 0·086, 0·188; P < 0·001). Increased USG, a sign of low hydration status and presumably high vasopressin, was associated with IR and poor fat distribution. Direct effect of low hydration status may be more dominant than indirect effect via IR or fat distribution. Further studies are necessary to confirm our findings.
Recent hospital fire incidents in South Korea have heightened the importance of patient evacuation. Moving patients from an intensive care unit (ICU) or emergency department (ED) setting is a challenge due to the complexity of moving acutely unwell patients who are reliant on invasive monitoring and organ support. Despite the importance of patient evacuation, the readiness of ICU and ED for urgent evacuation has not been assessed.
To enhance the readiness and competencies of workers from ICU and ED in the evacuation of patients during a simulated tabletop fire exercise.
A tabletop simulation exercise was developed by the Center for Disaster Relief, Training, and Research referencing the fire evacuation manual developed by the hospital’s ICU and ED. The scenario consisted of evacuating patients horizontally and vertically from each department. The participants’ actions were assessed using a checklist. A debriefing was completed after the exercise to discuss the gaps observed. A post-survey questionnaire was used to evaluate the exercise and assess the perception changes of the participants. All pre-to-post differences within subjects were analyzed with paired t-tests.
A total of 22 and 29 people participated in the exercise from ICU and ED, respectively. Knowledge and confidence improved post-exercise for both ICU and ED scenarios (p<0.05). Course satisfaction was 7.9 and 8.7, respectively for ICU and ED exercise. Correct performance rates for ICU and ED were 59% and 58%, respectively. Common gaps noted for both ICU and ED were wearing protective masks, patient hand-over communication, and preparation for resources.
There need to be exercises to recognize system gaps in place for hospital fire evacuation preparedness. Tabletop simulation exercises are ideal tools for this purpose. Although this was a short 90-minute exercise, this increased familiarity with the evacuation plan, tested the plan, and allowed for identification of gaps.
South Korea experienced Middle East Respiratory Syndrome (MERS) outbreak in 2015. To mitigate the threat posed by MERS, the Ministry of Health and Center for Disease Control designated hospitals to be responsible for managing any suspected or confirmed infectious patient. These hospitals receive mandatory training in managing infectious patients, but many of the trainings lack practical skills practice and pandemic preparedness exercise.
To develop and evaluate a training course designed to train healthcare providers from designated hospitals to enhance their competencies in managing emerging infectious diseases and potential outbreaks.
A two-day course was developed by the Center for Disaster Relief, Training, and Research in collaboration with the Korea Health Promotion Institute using Kern’s 6-step approach. The course consisted of didactic lectures, technical skills training, tabletop simulation, and scenario-based simulation. Table-top simulation exercises consisted of cases involving a single infectious patient detected in the outpatient clinic and outbreak in the emergency department. Scenario-based simulation exercises involved managing a critically ill infectious patient in an isolated ward. A post-survey questionnaire was used to evaluate the course and assess the perception changes of the participants. All pre-to-post differences within subjects were analyzed with paired t-tests.
A total of 121 healthcare providers participated in three separate courses. The competencies for pandemic preparedness knowledge, skills, and attitude improved from pre- to post-course. The differences were all statistically significant (p<0.05). Overall course satisfaction in average for expectation, time, delivery method, and contents were 9.5, 9.2, 9.4, and 9.2, respectively.
There needs to be tests and exercises to recognize gaps of systems in place for pandemic preparedness. Simulation exercises are ideal tools for this purpose. Although this was only a two-day intensive course, this increased familiarity with workflows, tested the coordination of workflows between different disciplines and allowed the identification of gaps.
This study aimed to investigate associations among spirituality, coping strategies, quality of life (QOL), and the effects of depression and anxiety thereon in cancer patients.
In total, 237 cancer patients referred to a psycho-oncology clinic at a university hospital in Korea were enrolled. After identifying predictors of patient QOL in a stepwise regression model, we developed a hypothetical path model wherein interpersonal coping was considered as a mediating variable between spirituality (meaning/peace) and QOL and wherein depression and anxiety affected each of these three variables.
The direct effect of spirituality (meaning/peace) on QOL was 36.7%. In an indirect model, interpersonal coping significantly mediated the relationship between spirituality (meaning/peace) and QOL. Depression exerted the largest negative effect on spirituality (meaning/peace), interpersonal coping, and QOL. Anxiety had negative effects on spirituality (meaning/peace) and QOL, but a positive effect on interpersonal coping.
Significance of results
Interpersonal coping strategies work as a partial mediator of the relationship between meaning/peace subscales of spirituality and QOL. Effective management of depression may help in achieving better outcomes associated therewith. Greater attention and efforts to improve social connectedness and meaning of life in spiritual well-being may improve the QOL of cancer patients.
Depressive symptoms are common in bereaved caregivers; however, there have been few prospective studies using a structured interview. This study investigated the prevalence and preloss predictors of major depressive disorder (MDD) in bereaved caregivers of patients in a palliative care unit.
This prospective cohort study collected caregiver sociodemographic and psychological data before the death of a palliative care unit patient, including MDD, care-burden, coping style, and hopeful attitude. Postloss MDD was assessed 6 and 13 months after death, and a multivariate logistic regression analysis was conducted to identify its predictors.
Of 305 caregivers contacted, 92 participated in this study. The prevalence of preloss MDD was 21.8%; the prevalences of postloss MDD were 34.8% and 24.7% at 6 and 13 months, respectively. Preloss MDD predicted postloss MDD at 6 months (odds ratio [OR] = 5.38, 95% confidence interval [CI95%] = 1.29, 22.43); preloss nonhopeful attitude and unemployment status of caregivers predicted postloss MDD at 13 months (OR = 8.77, CI95% = 1.87, 41.13 and OR = 7.10, CI95% = 1.28, 39.36, respectively).
Significance of results
Approximately 35% of caregivers suffered from MDD at 6 months postloss, but the prevalence of MDD decreased to about 25% at 13 months. Preloss MDD significantly predicted postloss MDD at 6 months, whereas hopeful attitude and unemployment at baseline were significantly associated with postloss MDD at 13 months.
The Sewol ferry disaster is one of the most tragic events in Korea’s modern history. Among the 476 people on board, which included Danwon High School students (324) and teachers (14), 304 passengers died in the disaster (295 recovered corpses and 9 missing) and 172 survived. Of the rescued survivors, 72 were attending Danwon High School, located in Ansan City, and residing in a residence nearby. Because the students were young, emotionally susceptible adolescents, both the government and the parents requested the students be grouped together at a single hospital capable of appropriate psychiatric care. Korea University Ansan Hospital was the logical choice, as the only third-tier university-grade hospital with the necessary faculty and facilities within the residential area of the families of the students. We report the experiences and the lessons learned from the processes of preparing for and managing the surviving young students as a community-based hospital. (Disaster Med Public Health Preparedness. 2017;11:389–393)
Echinochloa species are among the most troublesome weeds in
rice cultivation, and grow in a broad habitat range in Korea. Although
various ecotypes of Echinochloa have been collected as
germplasm for future studies, it has been difficult to classify them due to
their high level of morphological similarity. This study was thus conducted
to develop and investigate the phylogenetic relationships between 77
Echinochloa accessions with the use of 23 simple
sequence repeat (SSR) markers and 24 morphological traits. Of 77
Echinochloa accessions, including 57 accessions from
Korea and 5 reference species, late watergrass was clearly clustered as a
distinctive group from barnyardgrass and other Echinochloa
species. In this analysis, we also identified core genetic and morphological
markers that can be used for the future identification and classification of
Echinochloa species. Five out of 23 SSR makers produced
distinctive bands that discriminate late watergrass from barnyardgrass and
other Echinochloa species. Four morphological traits of the
reproductive organs were the most influential contributors for classifying
Echinochloa species. Although there was no clear
consensus generated in this study between SSR markers and morphological
trait analyses, our results support the potential use of the selected SSR
markers and morphological traits in future studies of
We report a simple and scalable process to synthesize the core–shell
nanostructure of MoS2@N-doped carbon nanosheets (MoS2@C),
in which polydopamine is coated on the MoS2 surface and then
carbonized. Transmission electron microscopy reveals that the as-synthesized
MoS2@C possesses a nanoscopic and ultrathin layer of
MoS2 sheets with a thin and conformal coating of carbon layers
(∼5 nm). The MoS2@C demonstrates a superior
electrochemical performance as an anode material for lithium ion batteries
compared to exfoliated MoS2 sample. This unique core–shell
structure is capable of excellent delivery of Li+ ion in
charging–discharging process: a specific capacity as high as 1239 mA
h g−1, a high rate of charging-discharging capability even
at a high current rate of 10 A g−1 while retaining 597 mA
h g−1, and a good cycle stability over 70 cycles at a high
current rate of 2 A g−1.
Cerebral white matter hyperintensities (WMH) are prevalent incident findings on brain MRI scans among elderly people and have been consistently implicated in cognitive dysfunction. However, differential roles of WMH by region in cognitive function are still unclear. The aim of this study was to ascertain the differential role of regional WMH in predicting progression from mild cognitive impairment (MCI) to different subtypes of dementia.
Participants were recruited from the Clinical Research Center for Dementia of South Korea (CREDOS) study. A total of 622 participants with MCI diagnoses at baseline and follow-up evaluations were included for the analysis. Initial MRI scans were rated for WMH on a visual rating scale developed for the CREDOS. Differential effects of regional WMH in predicting incident dementia were evaluated using the Cox proportional hazards model.
Of the 622 participants with MCI at baseline, 139 patients (22.3%) converted to all-cause dementia over a median of 14.3 (range 6.0–36.5) months. Severe periventricular WMH (PWMH) predicted incident all-cause dementia (Hazard ratio (HR) 2.22; 95% confidence interval (CI) 1.43–3.43) and Alzheimer's disease (AD) (HR 1.86; 95% CI 1.12–3.07). Subcortical vascular dementia (SVD) was predicted by both PWMH (HR 16.14; 95% CI 1.97–132.06) and DWMH (HR 8.77; 95% CI 1.77–43.49) in more severe form (≥ 10 mm).
WMH differentially predict dementia by region and severity. Our findings suggest that PWMH may play an independent role in the pathogenesis of dementia, especially in AD.
To determine the influence of caregiver personality and other factors on the burden of family caregivers of terminally ill cancer patients.
We investigated a wide range of factors related to the patient–family caregiver dyad in a palliative care setting using a cross-sectional design. Caregiver burden was assessed using the seven-item short version of the Zarit Burden Interview (ZBI–7). Caregiver personality was assessed using the 10-item short version of the Big Five Inventory (BFI–10), which measures the following five personality dimensions: extroversion, agreeableness, conscientiousness, neuroticism, and openness. Patient- and caregiver-related sociodemographic and psychological factors were included in the analysis because of their potential association with caregiver burden. Clinical patient data were obtained from medical charts or by using other measures. Multivariate linear regression analysis was performed to identify the independent factors associated with caregiver burden.
We analyzed 227 patient–family caregiver dyads. The multivariate analysis revealed that caregiver extroversion was protective against caregiver burden, whereas depressive symptoms in caregivers were related to increased burden. Neuroticism was positively correlated with caregiver burden, but this relationship was nonsignificant following adjustment for depressive symptoms. Patient-related factors were not significantly associated with caregiver burden.
Significance of Results:
Evaluating caregiver personality traits could facilitate identification of individuals at greater risk of high burden. Furthermore, depression screening and treatment programs for caregivers in palliative care settings are required to decrease caregiver burden.
Epidemiological studies have reported that higher education (HE) is associated with a reduced risk of incident Alzheimer's disease (AD). However, after the clinical onset of AD, patients with HE levels show more rapid cognitive decline than patients with lower education (LE) levels. Although education level and cognition have been linked, there have been few longitudinal studies investigating the relationship between education level and cortical decline in patients with AD. The aim of this study was to compare the topography of cortical atrophy longitudinally between AD patients with HE (HE-AD) and AD patients with LE (LE-AD).
We prospectively recruited 36 patients with early-stage AD and 14 normal controls. The patients were classified into two groups according to educational level, 23 HE-AD (>9 years) and 13 LE-AD (≤9 years).
As AD progressed over the 5-year longitudinal follow-ups, the HE-AD showed a significant group-by-time interaction in the right dorsolateral frontal and precuneus, and the left parahippocampal regions compared to the LE-AD.
Our study reveals that the preliminary longitudinal effect of HE accelerates cortical atrophy in AD patients over time, which underlines the importance of education level for predicting prognosis.
This study aimed to investigate the influences of age, education, and gender on the two total scores (TS-I and TS-II) of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological assessment battery (CERAD-NP) and to provide normative information based on an analysis for a large number of elderly persons with a wide range of educational levels.
In the study, 1,987 community-dwelling healthy volunteers (620 males and 1,367 females; 50–90 years of age; and zero to 25 years of education) were included. People with serious neurological, medical, and psychiatric disorders (including dementia) were excluded. All participants underwent the CERAD-NP assessment. TS-I was generated by summing raw scores from the CERAD-NP subtests, excluding Mini-Mental State Examination and Constructional Praxis (CP) recall subtests. TS-II was calculated by adding CP recall score to TS-I.
Both TS-I and TS-II were significantly influenced by demographic variables. Education accounted for the greatest proportion of score variance. Interaction effect between age and gender was found. Based on the results obtained, normative data of the CERAD-NP total scores were stratified by age (six overlapping tables), education (four strata), and gender.
The normative information will be very useful for better interpretation of the CERAD-NP total scores in various clinical and research settings and for comparing individuals’ performance of the battery across countries.